An accurate method of diagnosing and tracking the recovery from concussions and brain trauma has largely escaped even the most massive organizations in America.

The National Football League, which had $15 billion in revenue in 2018, has made a notable effort to limit head injuries on the football field as 214 concussions were reported in the 2018 NFL preseason and regular season.

Diagnosing concussions commonly relies on two very subjective and faulty processes: the imPACT test and a doctor’s interpretation of a patient’s response to questioning. However, Cortical Metrics, a biotechnology company based in Carrboro, and its Brain Gauge, created by Dr. Mark Tommerdahl, have a critical ingredient every previous form of concussion detection has been without: touch.

“One of the underlying principles of the science behind the Brain Gauge is that the nerves in adjacent fingertips project to specific and unique adjacent regions in the brain,” Cortical Metrics explains on its website. “The Brain Gauge sends gentle vibrations to your fingertips to precisely activate these nerves and areas in the brain.”

Cortical Metrics employees Eric Francisco and Jameson Holden showcased a demo of the Brain Gauge technology. The tests in the demo involved testing the patient’s reaction time to vibrations felt in the fingertips, selecting the stronger of two pulses at different times, selecting the stronger of two pulses at the same time and choosing the longer pulse at different times.

As the test moved forward, the discrepancy between the pulses became smaller. The lengths of the pulses can differentiate by just 25 milliseconds where the average human fails to tell the difference. The point in which the subject fails to pick up on the differences helps dictate the scoring.

Based on the scores, the software can determine eight different aspects of brain health for the participant: speed, accuracy, TOJ (temporal order judgment), time perception, connectivity, plasticity, fatigue, and focus. If the overall score dips below 80, it can raise questions about the current state of someone’s brain health. A concussion is typically present if a patient’s score deviates from 100 to 300 percent. A standard deviation is approximately 20 percent for a normal score.

For example, an athlete was green-lighted to return to action after a SCAT5 test, said CAP Corporation CEO Kim Adolphe. But after taking the Brain Gauge test (results below), it is easy to tell the athlete did not come close to achieving a score of 80, yet was told to return to action.

“The last soccer athlete we saw was told to go to a psychiatrist,” said Adolphe. “Here’s what her brain looked like….she said, ‘Finally I feel like someone understands what I am feeling and can help me.’”

“All other baseline tests including ImPACT and SCAT 5 are highly subjective,” said Adolphe. “According to the consensus Statement on Concussions, Zurich Concussion Guidelines have been found to be reliably unreliable. They no longer recommend them. These baseline tests inaccuracies were also collaborated with research conducted by the University of Windsor which found that as many as 55 percent of baseline tests were inaccurate.”

Cortical Metrics has built technology that returns a 90+ percent accuracy rate when diagnosing a concussion, compared to the imPACT test which misdiagnoses a healthy individual as one that is concussed 37 to 46 percent of the time. The imPACT test fails to have scores deviate from the baseline making it difficult to track the recovery process for a patient after a concussion.

Unlike the imPact test, “you can’t fake it” said Eric Francisco. The Brain Gauge’s responses are dictated by touch instead of critical thinking. The patient can deceive by purposely scoring a low baseline on the imPact test or misleading the doctor in hopes of returning to the field quickly.

Beyond the immediate impact of a blow to the head, the Brain Gauge can track someone’s brain capabilities over a lengthy period of time. An important tool to possibly learn more about Chronic Traumatic Encephalopathy, a degenerative brain disease developed through repetitive head trauma.

Dr. Ann McKee, a neuropathologist, examined 111 brains of deceased NFL players, per the New York Times. She found 110 of them had CTE, more than 99 percent. However, it must be noted the brains were submitted for research, meaning it was not a randomly sampled survey.

A huge market for head trauma diagnostics now exists for the immediate impact of a concussion but also the less noticeable, yet more devastating, long-term effects. The NFL has billions of dollars on the line each season making sure it produces the best product, but so do countless soccer and hockey leagues around the world that deal with common brain trauma as well.

Upwards of 20 sports teams including New Zealand and Australian rugby teams along with some Division I football programs have started to use Cortical Metrics’ technology. But athletics is just the tip of the iceberg.

The military has taken a keen interest in the technology in hopes of better understanding blast exposure. The test can be used in noisy environments since it relies on touch and not on visual or auditory perception.

Outside of head trauma, the gauge can be helpful in maximizing brain function after experimenting with different medications, hours of sleep, meditation, stressful periods, or cataloging the cognitive decline for someone that is aging. The aforementioned capabilities could be instrumental in penetrating an even bigger market.

The wellness market, now valued at $4.5 trillion across the world, via the Global Wellness Institute, could provide unlimited potential for the Brain Gauge which currently has a household option for $20 a month.

While the value of the Brain Gauge is immediately useful to athletes and the military, the real value of the Brain Gauge could lie in its future. As the emphasis on brain health grows across the world, why wouldn’t there be a future that has many consumers consistently tracking their brain health at home? People have scales and smartwatches to track their physical fitness. Why not a Brain Gauge to track their mental fitness?